UTERINE FIBROID FIBROIDS OF UTERUS ALSO KNOWN AS UTERINE LEIOMYOMAS OR FIBROIDS are benign smooth muscle tumors of the uterus. -Mostly fibroids are asymptomatic ,while some women experience painful and heavy bleeding. -If fibroids are large enough ,they may pressure on bladder causing frequent urination. -Fibroids run in families and appear to be partly determined by hormone levels. -Risk factors includes OBESITY. SIGNS AND SYMPTOMS -Abdomen pain with heavy bleeding leads to anaemia. -Depends on location of fibroid ,women may experience pain during intercourse. -During pregnancy ,fibroids may cause mis carriage , bleeding and premature labour. -Abdomen grows larger mimicking the appearance of pregnancy. REED’S SYNDROME Uterine fibroids with cutaneous leiomyomata and renal cell carcinoma. LOCATION AND CLASSIFICATION INTRA MURAL FIBROID -Located on muscular wall of uterus -Mostly fibroids are lagre and asymptomatic – They expand inwards causing distortion and elongation of uterine cavity. SUB SEROSAL FIBROID -Located on surface of uterus . -They can grow outwards from the surface and remains attached by a small piece Called PEDUNCULATED FIBROID ,they detach from uterus to become PARASITIC LEIOMYOMA. SUB MUCOSAL FIBROID -Located in the muscle beneath the endometrium of the uterus, even a small lesion in this location May lead to bleeding and infertility. CERVICAL FIBROID -Located in the wall of the cervix(neck of the uterus ) -Rarely fibroids are found in the supporting structures (round ligament, broad ligament or utero sacral ligament) FIBROIDS may be single or multiple ,secondary changes may develop with in the fibroid are hemorrhage,necrosis,calcification and cystic changes. EXTRA UTERINE FIBROIDS OF UTERINE ORIGIN -FIBROIDS of uterine origin located in other parts of the body ,sometimes also called PARASITIC MYOMAS,extremely rare ,they may be identical or metastasizing leiomyoma. The majority of fibroids remain asymptomatic (75%) Menorrhagia(30%)is the classical symptom of symptomatic fibroid Metrorrhagia or irregular bleeding may be due to -ulceration of submucous fibroid -torn vessels from the sloughing base of a polyp -associated endometrial carcinoma Dysmenorrhoea -cogestive associated with endometriosis or pelvic congestion -spasmodic associated with extrusion of polyp Infertility (30%)may be major compliant Pain in lower abdomen Abdominal swellings(lump)